Innovative drugs and their cost-effectivenesses

Abstract

Japan has been enjoying its unique health insurance system, under which almost every drug is covered, for over a half century. Only efficacies and safeties were considered during decision making process of approval/reimbursement and there were no room for consideration of efficiency, or cost-effectiveness. However, due to the rapid growth of total healthcare expenditure, there has been growing concern about the sustainability of our health care system. Government tried to implement health economic evaluation data (HTA data) into public health care system. It was introduced in 2016 as the pilot phase and will entirely be done in 2019. Unlike other countries which already introduced HTA systems, Japan would use HTA data for price revision of existing drugs. To upgrade our healthcare/HTA system, the role of appraisal, in which various issues other than the cost-effectiveness are considered, should be reconsidered. Health economic data should be used as a tool which can upgrade the value of new products and persuade various stakeholders who are anxious about the financial burden.